It is quite likely that you know someone – a close friend, a relative, or even yourself – who suffers from anxiety. With increasing stress and demands from social media, work, and day-to-day life, the incidence of anxiety has increased, and generalized anxiety disorder can affect up to a third of individuals over their lifespan. Many individuals rely on medication which may not fully eradicate symptoms, may have negative side effects, or may not help at all. However, recent research suggests that one answer to improving anxiety management may lie in an unlikely place: maintaining a healthy balance of gut bacteria.

Most of us have grown up with the understanding that “germs are bad” or “bacteria make you sick”. Attitudes such as these are commonplace, and yet they may not be the most appropriate. Despite our best efforts to remainĚýclean, bacteria are present everywhere we go – our homes, public transit, and even on every surface of our bodies. In fact, studies have demonstrated that 99% of the genes in our body actually come from various species of bacteria that reside on our skin and within our digestive tract. Even more surprising, the cells of our body are outnumbered approximately 9 to 1 by bacterial cells! Although many types of bacteria can be responsible for causing illnesses, the sheer number of bacterial cells in our bodies indicates that most bacteria are not disease-causing and some may even be beneficial to our health.

Over the last 15 years, a growing body of research has focused on the diverse ecosystem of bacteria, fungi and viruses residing in our gastrointestinal tract. All together this system is known as the microbiome, and it differs greatly from person to person. The 100 trillion microbes that populate our gut contribute to numerous functions that support our overall health including regulating immunity, absorbing nutrients, and vitamin production, as well as playing a role in our mental health. Interestingly, much like a fingerprint, every individual has their own unique gut microbiome which can be altered by a variety of factors.

So where does this gut microbiome come from? When we are born, our gastrointestinal tract is germ-free because the womb is sterile. Our first microbes come from the birth canal during normal birth, and following this, the general environment. Nutrients in breast milk such as fatty acids and complex sugars feed the bacteria that have colonized our gastrointestinal tract. During early childhood, the food we eat, germs we catch, and activities we engage in slowly solidify the bacterial population and diversity in our gut.

Interestingly, researchers have come to understand that this bacterial population can affect our brain and contribute to anxiety. The brain and the gut communicate through something researchers call . Neurotransmitters are chemicals within the brain that send information from one cell to the next. Many gut microbes can directly change the levels of these neurotransmitters, which might allow them to communicate with neurons. In fact, our gut microbes produce 90% of the serotonin (our feel-good neurotransmitter) in our body. Levels of this transmitter are associated with mood disorders, including anxiety. In germ-free mice with sterile intestines, there is significantly less serotonin found in the blood. This could indicate that gut bacteria signal the brain through release of neurotransmitters. Germ-free mice also have higher levels of the stress hormone corticosterone compared to the mice with a normal gut microbiota and, more importantly, when these germ-free mice were given a single bacterium, their dysfunctional stress response returned to normal. To further strengthen this idea, even short disruption of the balance of the gut, known as dysbiosis, has been linked to lower serotonin levels and anxiety like-symptoms in mice.

Other mouse studies show how the gut microbiota may influence our brain to produce anxious personality types. When germ-free animals were given bacteria from either normal or anxious mice, they took on behaviours from the donor mice, becoming either timid and fearful (markers of anxiety) or more exploratory. Looking to the human condition, we see that anxiety is a common symptom of individuals with irritable bowel syndrome (IBS). When gut bacteria from IBS or anxiety patients were given to mice, . While the majority of research is quick to link exercise to better physical and mental health, it turns out exercise may also increase the diversity of the gut microbiota and alter the levels of some bacteria which have been linked to anxiety.

Although most of these studies have been performed in mice, there is evidence from a growing number of human studies as well.Ěý One particularly interesting study found that . As sociability is normally associated with lower rates of anxiety and depression, the diversity of gut microbes may help predict whether these toddlers will develop anxiety disorders later in life and may in the future be an avenue that could be targeted for treatment.

One cautionary note remains to be discussed: the overuse of antibiotics, consumption of unhealthy foods, lack of sleep, and poor exercise habits can all play a role in reducing the health of our gut. It is possible, although still unknown, that the shift in our lifestyles from manual labour and home-cooked food to relatively static lives and fast food may be playing a role in the increased anxiety we currently face. Thus, simple lifestyle changes and healthy food choices (such as eating fruits, vegetables and fermented foods) to take care of our gut bacteria might be one route to happiness and good mental health.

References:

Sudo, N., Chida, Y., Aiba, Y., Sonoda, J., Oyama, N., Xiao-Nian, Y., Kubo, C., & Koga, Y. (2004). Postnatal Microbial Colonization Programs the Hypothalamic-Pituitary-Adrenal System for Stress Response in Mice. The Journal of Physiology.

Bercik, P., Denou, E., Collins, J., Jackson, W., Lu, J., Jury, J., Deng, Y., Blennerhassett, P., Macri, J., McCoy, K.D., Verdu, E. F., & Collins, S.M. (2011). The Intestinal Microbiota Affect Central Levels of Brain-Derived Neurotropic Factor and Behavior in Mice. Gastroenterology.

De Palma, G., Lynch, M.D., Lu, J., Dang, V.T., Deng, Y., Jury, J., … Bercik, P. (2017). Transplantation of Fecal Microbiota from Patients with Irritable Bowel Syndrome Alters Gut Funtion and Behavior in Recipient Mice. Science Translational Medicine.

Christian, L.M., Galley, J.D., Hade, E.M., Schoppe-Sullivan, S., Kamp Dush, C., & Bailey, M.T. (2015). Gut Microbiome Composition is Associated with Temperament During Early Childhood. Brain, behavior, and immunity.

Monda, V., Vilaano, I., Messina, A., Valenzano, A., Esposito, T., Moscatelli, F., Viggiano, A., Cibelli, G., Chieffi, S., Monda, M., & Messina, G. (2017). Exercise Modifies the Gut Microbiota with Positive Health Effects. Oxidative Medicine and Cellular Longevity.

Growing up, one of my favourite trips was to the doctor’s office. We would get in the car and drive to the doctor’s. I would sit in the waiting room, eagerly waiting for the moment the receptionist called out my name and said “please follow me to your room”. The doctor would finally come in, ask how I was doing and tell me to explain what I was visiting for. A few checkup procedures and five minutes later, I would walk out with a prescription in one hand, a sticker on the other, and torrent of thoughts in mind.

See, what fascinated me about the doctor’s office wasn’t the stickers (though I absolutely loved them). Rather, I was fascinated by how the doctor could ask me for a list of symptoms, check whatever was hurting me and figure out what was going on with my health. Health. What an awesome word. Five-year-old me was fascinated by health. What exactly was health? What did it encompass? Five-year-old me however, built a definition of health based on doctor visits and medical documentaries on television. I thought health only encompassed the physical human body. I thought that health could only be approached from a medical perspective, and could only be treated by doctors.

As I grew older though, I came across other words. Words like stress, anxiety, depression and eventually, mental health. With this, I learned that health was so much more complex than just the physical human body. The World Health Organization defines health as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” I particularly like this definition because it outlines all the other aspects of health I hadn’t been aware of, or really thought about when I pondered health.

The research project we are working on this summer is “Our Pets and Our Health: a photovoice pilot study.” This project is exploring how pets affect the health of people who are vulnerably housed or are dealing with homelessness. I vividly remember my first conversation with Dr. Kim Matheson on the project. During our conversation, she asked me if I’d ever heard of One Health. I hadn’t. When I shook my head and said “No,” she went on to explain what One Health meant. One Health is a multidisciplinary approach to health. It recognizes that human health is interconnected with the health of animals and the environment. It unites multiple fields for the improvement of health. To my great surprise, that one conversation with Dr. Matheson left me with a different understanding of health and many thoughts, insights and curiosity.

Just how closely is human health interconnected with animal health? This is one area of curiosity I just had to satisfy this summer. During the first few weeks of the summer, we spent time reading journal articles and familiarizing ourselves with the literature on this topic. The results of my readings? More insights. Even more curiosity. The benefits people derive from animals is incredible. From their great use in animal assisted therapy to the unconditional love and support they provide to people as pets, their important roles in the lives of people is unrivaled. I am really excited about the Our Pets and Our Health project, as it will provide us with more insights on how pets can positively impact the lives of vulnerable populations.

I never had any pets growing up. Due to this, I never really thought about the ways in which animals played a role in my life. I never thought that animal and human health could be interrelated, especially for someone who had never had a pet. However, working on this research project has allowed me to reflect on how animals have, in fact, played a role in my life. When I look back on my childhood, I have memories of walking to a park by the Rideau River with my family. My dad and I would feed the geese (though we probably shouldn’t have). We would go to hills and watch groundhogs come out. Despite not having a cat ourselves, we would play with the neighbourhood cats. Some of my favourite trips were those to the Agricultural Museum where we would watch horses, cows and other farm animals.

I recently talked to an uncle of mine who had gone on vacation. When I asked for pictures, I didn’t receive pictures of him. I was sent pictures of cats and baby goats. When I go through my camera roll on my phone, I find pictures I’ve taken of animals without giving much thought. Why is that? I’m starting to think it all goes back to One Health. Regardless of whether you’re a pet owner or not, you interact with animals and environment all the time. Ultimately, they do impact your health and play a very important role in your life. This summer has shown me that animals do play a role in our lives and discovering the health benefits we can derive from them is something I’m really looking forward to. I am eager to learn the findings of our research and to continue to expand my definitions, and understanding of health.

At least once a week, I make the mistake of looking at videos of dogs on Instagram and promptly text my boyfriend to tell him that I want a dog. When I drive by someone walking a dog, I seriously consider pulling over and asking to pet the dog. The biggest challenge in moving away from home for university was leaving behind my two dogs and three cats. I am pretty sure one of my parent’s biggest concerns is me adopting a dog or cat that I am not able to take care of. My future plans include raising a puppy and baby goat together so they grow up to become best friends.

So you might say I really like animals. More accurate, though, is that I love animals.

I especially find a certain kind of hope and love in rescue animals. Through the years, my family has been able to foster several dogs and several litters of kittens for various rescue organizations. All the pets we’ve owned have been rescued. Sometimes our pets proved challenging. When you have a rescue animal, there can be a lot of curveballs thrown your way. Some animals have had bad experiences with people, and you have to work to gain their trust. They might not have been trained properly or may have developed bad habits along their journey, and you have to train them to have proper manners. You might lose a few pairs of shoes and run outside in your bathrobe calling your pet’s name more often than you’d like, but that love in the animal’s eyes is so worth it in the end.

Growing up with animals, I took their presence for granted. I loved them and used them for support, but I never really considered the effect they had on my life until I moved away. Looking back, I see how my pets helped me through depression and anxiety. They were always there to listen and offer me their paw in support. Other times, I took comfort in seeing them bounce up to me and lick my face all over. Their happiness and love for life was contagious. Honestly, a few tears come to my eyes as I write this. The bond with them was so strong. Having animals that loved me so unconditionally truly gave me a reason to live. They were with me, and I knew I could face the day.

I was excited to move away from home for university. I looked forward to new experiences and challenges. But I underestimated how much I would miss my pets. My parents have even said that I probably miss the pets more than my human family. Facing the stressors of studies and relationship challenges without that constant, non-judgemental support and love was harder than I anticipated. I compensated for this by having pictures of my pets everywhere. When I skyped my family, I always had them bring the dogs and cats to the camera so I could talk to their very confused (and adorable) faces. I also visited the therapy dog in residence several times. My bond with my pets is one of the reasons I am so excited about this research. Given that I hadn’t even realized how they impacted me until I took time to consciously reflect, I am excited to see what data collection and analysis will reveal about the human animal bond.

I am a Neuroscience and Mental Health student. My own battles with mental health have made me extremely passionate about this issue. I want to both directly help people as well as research new ways of helping individuals that struggle. I am also passionate about rescuing animals and giving them the quality of life they deserve. When Dr. Matheson started describing the Pets and Our Health research project, I was beyond excited. I hadn’t heard of the One Health framework, the idea that the health of humans, animals, and the environment are related, or the Community Veterinary outreach, which provides veterinary services to individuals who would otherwise be unable to access animal care while also providing human health services. I didn’t know people were actually researching how animals effect our health.

Knowing the impact that animals have had in my life, even when I had a strong support network around me, I can only imagine how individuals who are homeless or vulnerably housed value their pets. During my internship, I’ve been reading journal articles about the relationship between vulnerable individuals and their pets. My eyes have been opened. For many of these individuals, their pets truly are their only supporters. They value the pets to the extent that it’s common to put the animal’s needs ahead of their own needs.

My hope through this research is that we are able to help to improve the quality of life for both people and their pets. I hope that the data that is collected will fuel further studies and provide a spark for future programs to help people and their pets in new ways. I hope that partnerships will form between different healthcare providers and animal organizations so that new, innovative ways of battling homelessness, mental illness, and animal neglect can be developed.

By Sarah Zutrauen, Department of Health Sciences

Revenge. It often seems to be the first thing to cross someone’s mind when they are wronged. It can seem satisfying in the moment. Even justified. ĚýBut is revenge actually sweet? Although vengeance may provide immediate satisfaction, it canĚýalso have unanticipated (and unwelcome) consequences for mental and physical health. On the flip side, the alternative response—forgiveness— may provide several benefits for health and well-being. But is this always the case?Ěý Both vengeance and forgiveness are often considered to be coping strategies used to deal with a variety of stressful events, but they can result in different outcomes, depending on the circumstances.

One of the most challenging types of stressful events to cope with (and potentially to forgive) is abuse. Following an abusive event, common psychological responses include a desire for revenge or avoidance, or a reluctance to forgive. Notably, women who have suffered abuse are at greater risk for subsequent stressor-related depression, posttraumatic stress disorder (PTSD), and other psychological symptoms. Abuse may also prompt the body to mount a short-term adaptive physiological response, by releasing stress hormones, such as cortisol, together with several brain neurotransmitters. However, sustained exposure to stressors, such as continued abuse, may lead to an overload of the stress response (allostatic overload), thereby diminishing cortisol levels, and decreasing the ability to deal with the stressor effectively. Ěý

Although vengeance mightĚýbe perceived as a fortifying option for women in abusive relationships and could feel good in the moment, it may be somewhat of a paradox in that it can also exact costs on psychological and physical health. But what about forgiveness?Ěý Is forgiveness good for health in the context of an abusive relationship? It has been suggested that forgiving reactions predict better psychological and physical functioning, including less severe depressive symptomatology (compared to not forgiving). As well, forgiveness is associated with diminished stress-related biological responses, such as lower heart rate, blood pressure, and skin conduction levels. However, in the context of abuse, forgiveness may actually comprise a two-edged sword. On one hand, forgiveness might foster resilience by buffering the negative psychological effects of abuse. On the other hand, it couldĚýbe detrimental if forgiving the abusive partner results in the continuation of the relationship, potentially putting the victim’s health at further risk. Thus, the positive health effects of forgiveness might depend on many factors, including the type or severity of the transgression (abusive or non-traumatic), as well as the type of well-being in question (physical or psychological).

Through two studies, researchers Renate Ysseldyk, Kimberly Matheson, and Hymie Anisman investigated the complex interactions among forgiveness, revenge, abuse, psychological health, and physiological stress responses among women who were currently involved in an abusive relationship, or had previously experienced intimate partner abuse (compared to women whose relationship conflicts were not abusive).

Psychological Health Implications

This research showed that women’s experiences of abuse, in general, were associated with greater depression and PTSD symptomatology. Women experiencing abuse were also more likely to desire revenge, and fewer engaged in forgiving behaviours. Interestingly, however, at low levels of psychological abuse (less than 3 events in the past month), revenge and depressive symptoms were unrelated, but at high levels of psychological abuse, a desire for revenge was related to higher depressive symptoms. Conversely, although forgiveness was associated with fewer depressive and PTSD symptoms in the absence of physical abuse, this association was even stronger in the presence of physical abuse.

Overall, unlike revenge and avoidance, forgiveness was associated with fewer psychological symptoms. It may be that unforgiving attitudes escalate negative emotions and rumination, leading to the development or maintenance of depressive or PTSD symptoms. In contrast, forgiveness may be key for the healing process through reducing feelings of hurt and resentment, thereby diminishing adverse psychological symptoms following abuse. Importantly, however, although the psychological health benefits of forgiveness were most pronounced in the aftermath of relatively severe offences, this was most evident for offences that were not ongoing. With women no longer in an abusive situation, forgiveness might be a strategy for letting go and moving on.

Physiological Stress Reactivity Implications

Alongside the psychological health responses that often accompany stressors, cortisol release is an adaptive short-term physiological response to help individuals cope. However, prolonged cortisol release, as might occur with ongoing abuse, isĚýharmful to both physical and psychological health. In this study, although revenge was associated with increased cortisol reactivity following reminders of any relationship stressor, elevated cortisol reactivity was also evident among forgiving women in ongoing physically abusive relationships (following reminder cues of an abusive event). However, among women who reported no physical abuse, forgiveness and cortisol reactivity were unrelated.

In effect, a blunted cortisol response was seen among women in an abusive relationship when they were not forgiving of their partner, while cortisol reactivity was intensified when forgiveness was given. This finding suggests the possibility that forgiveness acted as an adaptive response to the stressor, kicking physiological systems into gear in an effort to cope with the abuse. However, it is equally possible that forgiving may have prolonged the abusive relationship, and that the increased cortisol reactivity observed was actually a marker of women’s ongoing distress.

The Big Picture

Based on this research, in the context of an abusive relationship, is forgiveness sweet and revenge sour for health and well-being?

For the most part, revenge was sour. The desire for vengeance was associated with increased cortisol reactivity, as well as more symptoms of depression and PTSD among women enduring physical, and especially psychological, abuse.

In contrast, for the most part, forgiveness was sweet, if the abuse occurred well in the past. Forgiveness was also associated with increased cortisol reactivity in response to continuing relationships involving physical abuse. Thus, the sweetness of forgiveness implies letting go of resentment; it does not mean tolerating more abuse.

Overall, in the context of abusive relationships, the dual nature of forgiveness, the paradox of revenge, and the severity, type, and timing of abuse all contribute to the complex relations between these factors and women’s health. So, what should we do the next time we are hurt or wronged?Ěý Once we can be sure we are out of harm’s way, this research points to taking stock of the big picture, considering the potentially sour ramifications of continuing to seek revenge, and the comparativeĚýrelease that might be provided byĚýforgiveness.

Based on:

Ysseldyk, R., Matheson, K. & Anisman, H. (2017). Revenge is sour, but is forgiveness sweet? Psychological health and cortisol reactivity among women with experiences of abuse. Journal of Health Psychology. doi:

If you are experiencing any form of abuse, many resources exist, and those listed below may provide help:

………… 24 hour 1(866) 863-0511 TTY 1(866) 863-7868

………………………….24 hour (613) 238-3311

……………………………………..24 hour 1(877) 336-2433 ATS 1(866) 860-7082

“The land is everything. It’s family, it’s kin, it’s friends. It’s a part of you.”Ěý— Ashlee Cunsolo Willox, , Nov 25 2014.

Health geographer, community researcher, and environmental advocate, Ashlee Cunsolo Willox visited ĐÓ°ÉÔ­´´ University on February 5th to help convey the strong connections the Inuit have to the land, and the direct and indirect impacts of climate change.

In 2008, Cunsolo Willox was invited by the Rigolet community government to conduct narrative research regarding the impacts of climate change on health, where she identified, with the community, that mental health was a primary concern of community residents. Since then, she has worked with all five Inuit communities in Nunatsiavut, Labrador on a variety of community-led and community-identified research initiatives, including cultural reclamation and intergenerational knowledge transmission, suicide reduction and prevention, and land-based education and healing programs. “I’ve always said, that I work at a university, but [I work] for the communities.”

The Canadian Arctic has the fastest changing annual temperatures, and “this is a big deal… because of the sea ice, and it’s impacted ability to form,” says Cunsolo Willox. In 2012, Cunsolo Willox and a team of Inuit researchers from the communities launched the Inuit Mental Health and Adaptation to Climate ChangeĚýproject, to examine the relationships between people, places, cultures, environments, and mental health in the region.

There are approximately 2600 people living in Nunatsiavut, spread between five communities: Nain,ĚýHopedale, Postville,ĚýMakkovik, andĚýRigolet. Each community is located on the coast, and winter freezing is critical for transportation, obtaining supplies, and following traditional hunting patterns and sea ice is incredibly important for each community.

Nunatsiavut Inuit communities rely on, and thrive from, their natural environment; however, condition changes within the recent years has impacted their ability to access the land. Changes in annual temperatures have impacted animal migration patterns, weather behaviours, and sea ice integrity. Some Arctic animals are seeking cooler temperatures and migrating further north, while new animals, such as moose, are migrating into the Nunatsiavut communities. Changes in weather patterns, including increasing fog levels, wind speeds, and precipitation, are especially of concern as they impact sea ice formation and quality; sea ice that has traditionally supported travel, has a much shorter annual season.

Each change has an impact all aspects of Inuit lives and livelihoods and, as Cunsolo Willox and the research team discovered, the changes also have profoundly affected mental health, eliciting a major emotional responses across the region. Cunsolo Willox and the team identified from interviews with 120 people that “the biggest [effects] were those in mental health. The psychological impact of the changing climate was [initially] a big surprise.” Cunsolo Willox relayed one story about learning from an Elder in Rigolet: “She was telling me about…how the ice had changed. But what she wanted me to know most… was to understand the strong connections that Inuit have to the land. It’s everything… if you can’t get out on that land, it’s like you’ve lost a part of yourself. The land provides healing. It provides solace. It provides peace. So what happens if you can’t access that land anymore?”

These findings inspired production of the documentary film, “.” The film used interviews, scenery, and action shots throughout Nunatsiavut to conceptualize the deep connection between the Labrador Inuit and their homelands through their voices and lived experiences.

Interviews for “” revealed the importance of being able to access and connect with the land as a coping mechanism. Denied access to the land because of changing weather patterns meant loss of access to a place that supported reflection, and provided comfort. The inability to access the land due to insufficient sea ice formation directly and indirectly affects mental, and overall, health.

“Inuit are people of the sea ice. If there’s no more sea ice, how can we be people of the sea ice?”

Cunsolo Willox identified that these rapidly changing conditions impact the already over-burdened health systems, the path to health sovereignty, and the overall Inuit culture. Climate changes have yet added another colonial stressor that is out of their control. “It’s important to understand the past,” suggests Cunsolo Willox. Residents in Labrador were the first to have contact with European settlers more than 300 years ago. There is a long history of interaction, which includes residential schools, and relocation, and has resulted in intergenerational trauma. “And yet, they have such a rich culture. There is so much beauty in the region.”

Both Cunsolo Willox’s “heart and mind are in Labrador because [she’s] been there so long, [she has] relationships, and [has] seen so much evolution.” When asked what continues to inspire her, Cunsolo Willox simply responds “everything; it’s the beauty of the land; it’s the list of endless questions; it’s the discovery and sense of pride; the shared ownership of research; the communities.” While respect and willingness within the communities have eliminated most challenges, there are still barriers and hurdles at the provincial and federal governance level, especially as they relate to the funding of such interdisciplinary work. Despite these challenges, Cunsolo Willox “cannot imagine life without this work. I never expected it, and now, I cannot imagine working anywhere else. It’s changed me as an individual and my world-views; my interconnectedness. What I’ve learned from the people I’ve worked with, to listen to their wisdom, [it] has been a huge privilege.”

Photos by A. Cunsolo Willox

By Stuart J. Murray, Department of English Language and Literature, ĐÓ°ÉÔ­´´ University

Earlier this spring, I was asked to present my work on bioethics at the annual . In 7 minutes, I was to present a style presentation: 20 images, each displayed for 20 seconds, with my dynamic and charismatic voice-over. It was billed as an occasion to address government, industry, and community “stakeholders.”

I declined.

How could anyone repackage, in palatable sound bites, the ethical concerns plaguing Canada’s prison system, its crisis of mental health, its overuse of solitary confinement, its quiet racism, its suicides and homicides? The presentation format, which encourages chirpy advertising for applied research or “commercializable” outcomes, seems to forbid any serious discussion of an escalating crisis. Certain truths simply cannot be spoken in such a setting.

It some respects the Research Chairs Symposium is an apt metaphor for the prison system itself. Both impose a structural violence that is largely invisible, camouflaged by publicity extoling quantifiable “excellence,” statistics on economic efficiencies, and “accountability.” If we were to address these managerial abstractions on their own terms, we would be confronted with “content” that seems neither ethical nor unethical as such. But ethics is a question of form—the concrete ways that these structures affect the life of research and research into those lives (and deaths) lived within the structural confines of the prison.

Ethics is a matter of what can be said, thought, and brought to public consciousness. And yet, the terms that govern public presentation and deliberation impose a certain censorship. This is not simply to say that old-fashioned repressive measures stop people from speaking or publishing. We might call this a police function. More insidious, however, is the censoring violence that seems to come from nowhere, as if it emerged from and was recommended by the complex, anonymous system itself. By invisible hands.

Ashley Smith image taken from a coroner’s video. THE CANADIAN PRESS/HO

As an example, we might consider Ashley Smith’s treatment at the hands of the Correctional Service of Canada (CSC). On 19 October 2007, Smith, a mentally ill nineteen-year-old inmate on suicide watch, tied a ligature around her neck and strangled herself to death while in the care and custody of the CSC. Correctional officers watched and filmed the event from outside her cell (the in Canada is to video-record all strip searches and “use of force” incidents). Three front-line staff and one correctional manager were initially charged with criminal negligence causing death, but these charges were soon dropped; prison staff were merely following the warden’s orders not to enter the cell “if she’s still breathing.” Effectively, nobody was responsible for this death, even after the jury in the declared her death a homicide: death at the hands of an anonymous system, as it were.

During her final year of custody, spent almost entirely in solitary confinement, Smith was transferred 17 times between 9 different institutions across 5 provinces. Each transfer re-set the clock on her seclusion, sidestepping legal limits for the length of time it can be used. Several depict Smith being forcibly restrained by multiple correctional officers (or were they healthcare providers?) outfitted in full riot gear; another video depicts one of Smith’s extralegal transfers between facilities, hooded and being duct-taped into the seat of an airplane, pleading with her captors. Mental illness in the guise of terrorism, calling for counter-insurgency measures, it would seem. In this light, the system must be understood as remarkably coordinated across and between correctional facilities—a structural violence if ever there was one. Staff were instructed to lie and about Smith in order to give the illusion that efficiency and accountability prevailed in their institutions. In terms of mental health care, of course, this is a picture of utter inefficiency and unaccountability, with no apparent justification other than cruelty and violence themselves.

The censorship of repressive police functions often operates hand-in-hand with a structural violence that is more furtive because it is invisible, anonymous, systemic, and complex. The gears and mechanisms of these structures are further eclipsed by the celebratory din of managerial efficiency, accountability, and excellence. The spectacle is essentially empty, but it represents the new face of our public research universities, “colonized,” as have recently argued, by a “mercenary army of professional administrators, armed with spreadsheets, output indicators and audit procedures, loudly accompanied by the Efficiency and Excellence March.” Meanwhile, government and media-sponsored discourses on security and risk—PechaKutcha style—serve to justify in moralizing sound bites the police function, and shore up the structures meant to ensure public security and mitigate risk. Public research funds are hijacked by government, redirected to business “partnerships,” ushering in a new “” for Canadian science. The new fundamentalism silences scientific evidence.

The strategy is not working, although it may win votes. According to the , Canada’s prisons are sites of racialization and hyperincarceration of people of colour, notably for Black and Aboriginal populations. reports in particular that the number of incarcerated Aboriginal (self-identified Inuit, Innu, Métis and North American Indian) persons is disproportionately high: 33.0% of incarcerated women, 22.6% of men, while Aboriginal adults represent barely 3.0% of the Canadian population—an over-representation that far exceeds the per capita over-representation of African-Americans in the U.S. prison system.

31% of offenders in segregation units self-identify as Aboriginal. However, these statistics only represent federal institutions, not provincial ones. They do not include the many institutions that run segregation facilities known euphemistically as “alternative housing arrangements, secure living environments, special needs units, mental health units, intensive support units or gang ranges.” The flippantly refers to these as “Segregation ‘Lite’.” These provincial units operate outside of administrative segregation law, and therefore, according to the Correctional Investigator, “do not have [the] appropriate level of procedural safeguards/oversight.” Despite what our prime minister , these are sociological problems.

How do we come to terms with these numbers and the concrete lives they represent? And what is our responsibility, as a society, in the care of those who are imprisoned and, increasingly, diagnosed with a mental illness? Structural violence is social violence. If we think that ethics is limited to what it is right or wrong to do, this remains far too abstract unless we can account for the structural conditions under which something will appear for us as right or wrong—as well as the terms in and by which we think these thoughts, communicate them, and deliberate them publicly.

Language is not a neutral structure in this regard; it is not simply a tool, but rather actively structures our relations with others. One essential task of ethics is to intervene into the structural conditions to make these truths speakable, to bring them to public consciousness, and to foster critical dialogue. In other words, it is an ethical injunction to create conditions for public discourse, and to expose the invisible hands that manipulate in advance what truths can be spoken, when, where, and to whom.

Forthcoming inĚýAPORIA: The Nursing Journal

Based on

Murray, S.J., & D. Holmes (forthcoming). Seclusive space: Crisis, confinement, and behavior modification in Canadian forensic psychiatry settings. In Extreme Punishment: Comparative Studies in Detention, Incarceration, and Solitary Confinement. Eds. K. Reiter & A. Koenig (Palgrave-Macmillan).

Murray, S.J., & D. Holmes (2014). “,” truth-out.org (10 March).

Holmes, D., & S.J. Murray (2014). Censoring violence: Censorship and critical research in forensic psychiatry. In Power and the Psychiatric Apparatus: Repression, Transformation and Assistance. Eds. D. Holmes, J.-D. Jacob, & A. Perron (Ashgate Publishing), 35–45.

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